Publication Date:
2004-11-16
Description:
Intestinal thrombotic microangiopathy (TMA) after allogeneic stem cell transplantation is emerging as a major clinical issue, which is different from aGVHD in pathogenesis and clinical management. We performed a retrospective analysis of 140 pediatric patients with acute leukemia (82 ALL and 58 AML) who underwent allogeneic stem cell transplantation in Japanese Red Cross Nagoya First Hospital from 1991 to 2003 (69 from HLA matched sibling, 13 from HLA mismatched family donors and 58 from unrelated volunteer donors). Blood type was matched in 78 patients and mismatched in 62 patients (25 in minor , 26 in major and 11 in bidirectional). Seventeen patients developed intestinal TMA with a cumulative incidence of 13%. The median time to onset was 28 days (range, 10–104 days). Intestinal TMA was defined histopathologically by colonoscopic biopsies in 7 patients and bloody diarrhea and laboratory findings. Intestinal TMA occured in 28% of ABO minor mismatched transplantation, 32.5% of bidirectional, 14.4% of major mismatched and 5.8% in matched transplantation (p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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